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This is good! This means that some of the findings that are positive for CCSVI and for the improvements seen after venoplasty are being reported in a neurology journal. We've seen such a divide between the two disciplines of neurology and interventional radiology, and what they are hearing and saying about CCSVI.

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I like Dr Ferral's words:“These important results revealed that for people with MS who experience debilitating symptoms, minimally invasive interventional radiology treatments can be an effective, palliative treatment that also may improve their quality of life,” said Dr. Ferral. “As interventional radiologists, our biggest challenge is to bring to the attention of other specialists, especially those physicians specialized in MS, the evidence that venous lesions, often classified CCSVI, may be a true entity that deserves further attention and serious research,” he explained.This should not threaten Neuros too much, a sensible move.

Unfortunately, Neuros will expect double blind trials:"As we are still early in fully understanding the condition and its relation to treatment of CCSVI, it is our hope that future double-blinded prospective studies will be performed to further assess the durability of these results,” Dr. Mandato concluded.Anyone care to explain to Dr Mandata that blinding is impossible to an awake patient as inflating a balloon can can be felt??

I am thinking that even if the placebo test subjects are sedated, there are other things you can tell to make you know if you actually received the full treatment. My groin was quite bruised, which I attribute to the insertion and manipulation of the tubes and all. It was far worse than a simple cut alone would cause. And, I had neck discomfort from the actual ballooning.

I just don't think that if I had received a sham procedure that I would not know that.

Placebo interventions are often claimed to substantially improve many clinical conditions. However, most reports on effects of placebos are based on unreliable studies that have not randomised patients to placebo or no treatment.

We studied the effect of placebo treatments by reviewing 202 trials comparing placebo treatment with no treatment covering 60 healthcare problems. In general, placebo treatments produced no major health benefits, although on average they had a modest effect on outcomes reported by patients, such as pain. However, the effect on pain varied from large to non-existent, even in well-conducted trials. Variations in the effect of placebo was partly explained by variations in how trials were conducted, the type of placebo used, and whether patients were informed that the trial involved placebo.

Cochrane review of placebo interventions for all clincial conditions finds that placebo produces no major health benefits.

In analysing the placebo groups of 26 major randomised placebo controlled clinical trials published in the literature, the researchers from the UK and Germany found that on average, those in the placebo group had an annual relapse rate reduction of 6.2% (p<0.0001). The very low p value indicates that this was not a chance result. So in a study that took 10 years to complete, this would equate to around a 50% reduction in relapse rate in those who received no active treatment.

In analysing the placebo groups of 26 major randomised placebo controlled clinical trials published in the literature, the researchers from the UK and Germany found that on average, those in the placebo group had an annual relapse rate reduction of 6.2% (p<0.0001). The very low p value indicates that this was not a chance result. So in a study that took 10 years to complete, this would equate to around a 50% reduction in relapse rate in those who received no active treatment.

This is hooey. The one-year cohort would go through the same change as the ten-year, and only once; a change from nothing to treatment. The relapse rate decrease does not accelerate, unless you are actually curing the disease, say by killing germs. I don't think anybody is claiming placebo does that. It can not treat disease, otherwise it could cure cancer. Ask anybody dying of it if they believe that.

I believe if you could see all my posts you would find at least one referencing Cochrane. They publish this result periodically, I believe. So my question is, if placebo can never actually treat anything, how can anyone justify giving it to people, and not even the treatment under question? I think people are routinely denied treatment so that they will accept being used in randomized placebo-controlled trials.

In analysing the placebo groups of 26 major randomised placebo controlled clinical trials published in the literature, the researchers from the UK and Germany found that on average, those in the placebo group had an annual relapse rate reduction of 6.2% (p<0.0001). The very low p value indicates that this was not a chance result. So in a study that took 10 years to complete, this would equate to around a 50% reduction in relapse rate in those who received no active treatment.

This is hooey. The one-year cohort would go through the same change as the ten-year, and only once; a change from nothing to treatment. The relapse rate decrease does not accelerate, unless you are actually curing the disease, say by killing germs. I don't think anybody is claiming placebo does that. It can not treat disease, otherwise it could cure cancer. Ask anybody dying of it if they believe that.

It could be regression to the mean. If patient selection is of patients who have atypically active MS, those patients naturally 'regress' to a more average amount of MS activity as measured by lesions and relapses, with or without treatment.

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